Medical and Geriatric Wards PLEASE READ

I thought I would put this here so anyone who might read this can understand where I work and where I am coming from. I am going to try and keep this as simple as possible.

This blog is a portrayal of working on a 25 bed medical ward in the NHS. Medical wards take people with GI bleeds, Heart problems, Renal problems, Pneumonia, Lung disease, cancer, asthma, sepsis, general deterioration etc etc etc. This means that we are a mainly a geriatric ward. Most people who need to be hospitalized with these problems are elderly. The majority of my patients are completely unable to care for themselves due to extreme illness or dementia. Usually both together. The majority are confused. A severe medical illness will do that to you even if you were totally with it last week.

The opposite of this ward is a general surgical ward. These wards usually have younger patients who have a problem that needs sorting and that is the end of it. Think of the 26 year old male with a hernia. He goes in and has his hernia done. He has no other problems and is self caring. He goes home the same day. Sometimes surgical wards get really sick patients with severe problems but because the nurse's other patients are mainly self caring she can focus on the ill patient without leaving her other patients sat in shit for 4 hours.

The surgical ward is always better staffed than the medical wards. Always. Our hospital has a short stay surgical unit. They take easy cases. Young men like the one I described above are the norm down there. They will never take elderly medical patients as they are usually not suitable for an operation i.e. they'll probably die on the table. They have 15 self caring young patients who have no major medical problems. They get 3 nurses and 1 health care assistant for those 15 patients.

Cardiac wards are staffed in a similiar fashion but are also a lot busier. Even so, a nurse on a cardiac ward will often not have more than 5 patients some of whom are self caring and orientated. Compare this to a medical/elderly ward where the nurse has 15 patients and not one of them can feed themselves. Medical nurse will also have acutely unwell patients who could die if she leaves them long enough to help her more medically stable patients who are incontinant and struggling with basic hygeine.

Orthopedics is usually staffed well compared to medical/elderly and if one of their patients starts going down hill they are immediately sent to a medical ward where the nurse is caught between 20 elderly patients who need to be fed anc cleaned and the patient who came from the ortho ward who is now dying of heart failure because they overloaded him with IV fluids.



This blog is about working on a medical/elderly ward. It is an accurate represention of that without breaching confidentiality.

It is not an accurate representation of your nan's orthopedic ward where she had her hip done, or the surgical ward where you had your tonsils out, nor is it any kind of portrayal of cardiac wards. It is a whole different world from ITU and CCU where the nurse has 1 or 2 patients and massive back up.

My ward is a medical ward. This is the one your grandfather will go to after CCU stabilizes him, or maybe he isn't stable at all when he comes to me and I have to prioritize his care above hygeine care for other patients in order to ensure his survival. My ward is the one where nursing home patients go to when the nursing homes and their families cannot cope and there is no other place for them to go. They are medically stable when they come to me but are confused, malnourished, immobile, aggressive and incontinant and demand one to one care and so do their relatives. The relatives do not give a shit if I have a 30 year old mum down the bottom of the ward who can't breathe and needs a neb and a zillion other interventions to get even remotely comfortable. They don't care that I have a 63 year old who is raising her grandchildren and is now bleeding out due to a GI bleed and needs blood. They will tear me apart for leaving their elderly relative long enough to stablize the others. But the lawyers would tear me apart if I dared to leave an unstable medical patient to take another patient to the toilet. The nurses on my ward are in this position every minute of every shift they work. They are constantly caught between doing basic care for the elderly without harming someone is acutely medically ill. I cannot speak for nurses on surgical, ortho, cardiac, and intensive care wards.

I like caring for elderly people as challenging as it is. I see an old woman and I know that once she was someone's beautiful baby, someone's child who made mummy and daddy so proud. She was a gorgoeus, intelligent and vibrant young woman with plans for her life. She was someone's sweetheart and bride.

My elderly patient with dementia was someone's wife and the glowing mum to a new baby once. She was a shoulder to cry on for her older children and she probably busted her ass to care for her own aging parents as well as her own family. I know that if my own babies live a long time they are sure to end up like the old woman I see in front of me and I hope someone cares for them in their old age.


I know this and my colleagues know this. All of us.

So why does the public think that we hate old people? We don't hate old people. But society and our bosses certainly do.

Read the blog to see what shifts are like for nurses on these wards.